Student Handbook and Planner Acknowledgment

Today's Date Today's Date * / MM / DD YYYY
Name Name * First Last
Student ID Number (located on Student ID or schedule)
Start with the letter "U" followed by 8 digits * *
Program *

Program First option Second option Third option Barbering Certified Nursing Assistant (CNA) Child Development Associate College Preparation Cosmetology Culinary Arts Customer Service Professional Emergency Medical Technician English for Speakers of Other Languages (ESOL) High School Equivalency Home Health Aide Licensed Practical Nurse Medical Secretary Office Support Specialist Pharmacy Technician Pre-Vocational Studies Security Guard Sterile Processing Technician Teacher Assistant
Email
Phone Phone * - ### - ### ####
Address Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
I acknowledge that I have completed the new student orientation and will adhere to the student policies and procedures as outlined in the REOC student handbook. *

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.